If you're feeling a bit brain-fogged these days, you might not be wrong to blame it on the heat.

Several summers back, researchers in Boston studied young adults living in college dorm rooms during a heat wave. Some had central AC and slept at a cool 71 degrees Fahrenheit. Others slept in rooms without air-conditioning, where the temperature hovered around 80 degrees.

Each morning for nearly two weeks, the students took a few tests, administered on their cellphones. The people who slept in the hotter dorm rooms performed measurably worse on the tests.

The tests included a math test requiring simple addition and subtraction and a second test, the Stroop test, that jumbles colors and words. "So, if I show the word 'red' in the color blue, participants have to respond 'blue,'" says study author Jose Guillermo Cedeño Laurent, an assistant professor at the Rutgers School of Public Health.

It's easy to get tripped up if your attention or reaction time is slowed, he says, and that's exactly what heat appears to be doing. "The magnitude of the effect was really striking," Cedeño Laurent says. "We saw reductions in the order of 10% in their response times and also their accuracy."

Part of this effect may be explained by interrupted sleep. It can be hard to get a good night's rest if you're not accustomed to the heat, and a lack of sleep could certainly impair reaction time and focus. But there's a body of evidence suggesting it may be something about the heat itself that interferes with cognition.

A similar study published in 2021 also documented a dip in cognitive performance at air temps of 79 degrees. Researchers found that as the temperature rose, activity in the parasympathetic nervous system, the anti-stress system that can help us stay calm and relaxed, was lowered. Plus oxygen saturation levels in the blood were lower at the elevated temperatures as well, which the researchers said could be expected to result in reduced cognitive performance.

Other studies have found an effect from heat on office workers and on standardized test score performance, says Caleb Dresser, an emergency medicine physician who also serves as the director of health care solutions at the Harvard Chan Center for Climate, Health and Global Environment.

One of these studies showed that productivity in the workplace is highest when the air temperature is about 72 degrees, and productivity starts to drop off in the mid-70s. Another shows that for high school students, taking a standardized test on a hot day is linked to poorer performance.

Dresser says the evidence suggests that heat can influence us in sometimes-indiscernible ways. "All of these [studies] seem to point to a reduced ability to think clearly and quickly and efficiently when the body is too hot," he says.

There's also research to suggest that heat can make you moodier or irritated, in part perhaps by raising cortisol levels and inducing a stress response.

Of course, you can acclimate to heat after several days of exposure, and our bodies have several built-in coping mechanisms that help us cool down. For instance, you'll begin to sweat sooner and blood flow to the skin increases, which can carry heat away from the body's core.

But given the extreme heat waves that are becoming more common, there's increasing interest in better understanding the mechanisms by which heat may exacerbate or set off mood and anxiety-related problems. Dresser points to a study published in JAMA Psychiatry in 2022 that found hospital ER visits for mental health conditions rise during extremely hot days.

"I think this is consistent with what a lot of physicians will tell you if they have worked during hot conditions," Dresser says. Mental health is a concern all of the time, "but it can become a bigger concern during really hot conditions," he says.

Multiple factors likely explain how heat exacerbates the risks, beyond changes in stress hormones and sleep disturbances. Dresser points out that there's an overlap between populations who are vulnerable to mental health issues and populations that are unhoused or have intermittent access to housing.

And, clearly, if someone is living outside during a heat wave, there's a greater likelihood of significant impact. "There may be complicated social issues going on," he says.

A better understanding of all of these factors could help inform strategies to prevent or manage the challenges. "As we learn to live in a warming world where the summers are getting hotter, we need to be extra alert to recognize when conditions are dangerous and take steps to stay safe," Dresser says.

One of the key strategies is to stay well-hydrated. This may sound obvious, but dehydration is common in the summer, and many people underestimate how much fluid they need to replace when they're sweating a lot or spending time outdoors.

In fact, the participants in the college dorm study benefited from staying well-hydrated. During the study, the researchers sent text messages asking all the participants how much liquid they'd consumed, and it turned out that the participants who slept in the hot dorm rooms and drank fewer than six glasses of liquid per day performed worse on the tests. And prior research has shown that being even a little dehydrated can impair cognitive performance.

It's a reminder that a simple step — remembering to drink plenty of water — can help protect not just our physical health, but our mental well-being, too.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Transcript

A MARTÍNEZ, HOST:

All right, it's no surprise that extreme heat can put our bodies at risk. But what's been less understood is how heat waves can influence our cognition and mood. NPR's Allison Aubrey reports there's increasing evidence that living in hotter conditions can slow down our thinking and may make us cranky or irritated as well.

ALLISON AUBREY, BYLINE: It's well known that babies, children and elderly people can be vulnerable to the heat. But several summers back, researchers on a college campus in Boston wanted to know how young adults living in college dorms were influenced by a heat wave. Here's study author, Memo Cedeno Laurent.

MEMO CEDENO LAURENT: We were able to study students living in these dormitories. Some of them have air conditioning, and some of them didn't have.

AUBREY: Every morning for 12 consecutive days, the students took two quick tests administered on their cellphones. One was simple math - addition and subtraction - and a second test called the Stroop test, jumbles colors and words with the aim of confusing you.

CEDENO LAURENT: So, for example, if I show the word red in the color blue, participants have to respond blue.

AUBREY: It's easy to get tripped up if your attention or reaction time is slowed, says Cedeno Laurent, who's now an assistant professor at Rutgers University. And that's exactly what happened with the young adults sleeping in dorms with no AC. They did worse on the tests.

CEDENO LAURENT: The magnitude of the effect was really striking. So we saw reductions in the order of 10% in the response times and also their accuracy to these cognitive tests.

AUBREY: The air-conditioned dorms averaged about 71 degrees compared to 80 degrees in the dorms with no AC - only a 9 degree difference. But for people who aren't used to the heat, the warmer dorms may have disrupted their sleep, which may help explain the poorer test scores. Physician Caleb Dresser of the Harvard School of Public Health says the findings fit with a broader body of evidence.

CALEB DRESSER: There have been studies on students, on older adults, on office workers. There have been studies looking at standardized test score performance. And all of these seem to point to a reduced ability to think clearly and quickly and efficiently when the body is too hot.

AUBREY: Beyond slowing down our thinking, Dr. Dresser, who's an emergency medicine physician, says there's also evidence that heat waves can influence mood and anxiety. He points to a study published last year in the medical journal JAMA Psychiatry based on a 10-year evaluation. It found hospital ER visits for all kinds of mental health conditions rise when it's very hot outside.

DRESSER: I think this is consistent with what a lot of physicians will tell you if they have worked during hot conditions, which is that people can be having a rough time. And mental health issues certainly are a concern all the time but can sometimes become a bigger concern during really hot conditions.

AUBREY: Multiple factors may explain how heat could exacerbate anxiety, aggression or even agitation. For instance, hot conditions may induce a stress response and drive up levels of the stress hormone cortisol. Heat can interfere with good sleep, which can also influence mood. And Dr. Dresser says in terms of increased hospital visits for mood- and anxiety-related conditions, there could also be a broader explanation.

DRESSER: People who are living with mental health issues - that's a population that also overlaps with being unhoused or maybe having intermittent access to housing. And so there may be more complicated social issues going on.

AUBREY: A better understanding of all these factors could help inform strategies to prevent or manage these challenges. And Dr. Dresser says what is clear is that heat is increasingly a public safety issue.

DRESSER: What that means for all of us, as we learn to live in a warming world where the summers are getting hotter, is that we need to be extra alert to recognizing when conditions are dangerous and taking steps to stay safe.

AUBREY: One of the key steps to stay safe is to stay well hydrated, which may sound so obvious, but it turns up time and time again in cases of heat-related illness. And even in the college dorm study, it turned out that students who slept in the hot dorms but stayed well hydrated did better on the tests - a sign that something as simple as drinking more water can help protect not just our physical health, but our mental well-being too.

Allison Aubrey, NPR News. Transcript provided by NPR, Copyright NPR.

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